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  1. Subramaniam K, Siew SF, Mahmood MS
    Malays J Pathol, 2019 Apr;41(1):51-54.
    PMID: 31025638
    Spontaneous coronary artery dissection is a rare event and commonly associated with pregnancy and female gender. This condition can reduce or completely obstruct the blood flow to the heart, causing a myocardial ischaemia, abnormalities in heart rhythm or sudden death. We present a case of a 28-year-old Indian male with no previous medical illness who complained sudden onset of chest pain prior to his death. Autopsy revealed a left anterior descending coronary artery dissection associated with plaque rupture. The anterior wall of left ventricle showed contraction band necrosis. There was also atheroma present in the right coronary artery which was insignificant. Histologically, dissection was associated with atherosclerosis. There was no evidence of vasculitis. The cause of death was given as coronary artery dissection due to coronary artery atherosclerosis.
    Matched MeSH terms: Female
  2. Borges FK, Bhandari M, Patel A, Avram V, Guerra-Farfán E, Sigamani A, et al.
    BMJ Open, 2019 05 01;9(4):e028537.
    PMID: 31048449 DOI: 10.1136/bmjopen-2018-028537
    INTRODUCTION: Annually, millions of adults suffer hip fractures. The mortality rate post a hip fracture is 7%-10% at 30 days and 10%-20% at 90 days. Observational data suggest that early surgery can improve these outcomes in hip fracture patients. We designed a clinical trial-HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) to determine the effect of accelerated surgery compared with standard care on the 90-day risk of all-cause mortality and major perioperative complications.

    METHODS AND ANALYSIS: HIP ATTACK is a multicentre, international, parallel group randomised controlled trial (RCT) that will include patients ≥45 years of age and diagnosed with a hip fracture from a low-energy mechanism requiring surgery. Patients are randomised to accelerated medical assessment and surgical repair (goal within 6 h) or standard care. The co-primary outcomes are (1) all-cause mortality and (2) a composite of major perioperative complications (ie, mortality and non-fatal myocardial infarction, pulmonary embolism, pneumonia, sepsis, stroke, and life-threatening and major bleeding) at 90 days after randomisation. All patients will be followed up for a period of 1 year. We will enrol 3000 patients.

    ETHICS AND DISSEMINATION: All centres had ethics approval before randomising patients. Written informed consent is required for all patients before randomisation. HIP ATTACK is the first large international trial designed to examine whether accelerated surgery can improve outcomes in patients with a hip fracture. The dissemination plan includes publishing the results in a policy-influencing journal, conference presentations, engagement of influential medical organisations, and providing public awareness through multimedia resources.

    TRIAL REGISTRATION NUMBER: NCT02027896; Pre-results.

    Matched MeSH terms: Female
  3. Sidi H, Midin M
    The compulsive behaviour of observing an unsuspecting person undressing or being naked in voyeurism may be related to Obsessive-Compulsive spectrum disorder. The aim of this paper is to report a case that reiterates a unique psychopathology of a Malaysian male voyeur with an obsession on female body parts. This 35 year-old voyeur man who attended psychiatric outpatient clinic in an academic medical centre presented to a psychiatrist for taking photos of his sisters' naked bodies and collected nails and hairs from their body, coded them with intend for masturbation. His voyeuristic thoughts and urges which came repeatedly and intrusively, involving attempts to resist them and was associated with an inner tension for the urges to be fulfilled. He responded both to Paroxetine and behaviour therapy. The possibility that voyeurism, a paraphilia can manifest itself as a subtype of OCD is discussed. Keywords: Malaysian voyeur, obsession-compulsive spectrum disorder, body parts
    Matched MeSH terms: Female
  4. Siti Zuhaidah Shahadan, Muhammad Lokman Md. Isa, Azlina Daud, Ali Aminuddin Mohd Rasani, Muhammad Ibrahim, Samsul Deraman
    MyJurnal
    Introduction: Abdominal obesity and inflammation are two independent risk factors for cardiovascular disease. However, the inter-relationship between these two factors among Malay population is fragmented. The purpose of this study is to determine the association between waist circumference as a measure of abdominal obesity and high-sensitivity C-reactive protein as an indicator of inflammation status among Malay obese adults in Kuantan, Pahang. Materials and Methods: Ninety-three apparently healthy obese adults (BMI between 27.5 and 39.9 kg/m2 ) aged between 20 to 62 years old were recruited in this study (68% men and 32% women). Circumference tape was used to measure the waist circumference and fasting venous blood was obtained to determine the high-sensitivity C-reactive protein level. Results: On average, the waist circumference of obese men and women was 103 cm (SD = 8.7) and 94 cm (SD = 7.0), respectively. The median (IQR) of the hs-CRP level of the study participant was 3.80 mg/L (1.5, 10.1). The Kendall’s Tau correlation reveals that there is a significant positive linear correlation between waist circumference and hs -CRP level in obese men (r (30) = 0.355, p = 0.006) and women (r (63) = 0.177, p = 0.043). Conclusion: There is a significant inter-relationship between waist circumference and hs-CRP level among apparently healthy obese adults in Kuantan, Pahang. This study suggests that assessment of hs-CRP level is beneficial to predict the risk for future cardiovascular disease event and facilitate the management of obesity in this population. A prospective clinical study is recommended to confirm the findings.
    Matched MeSH terms: Female
  5. Muhammad Naimmuddin Abdul Azih, Aishah Ibrahim, How, Soon Hin, Kuan, Yeh Chunn
    MyJurnal
    We report a 55-year old lady with the presentation of stridor and type II respiratory failure requiring tracheal intubation. She had right Horner’s syndrome associated with pleural effusion. Her chest radiograph revealed right upper zone lobulated opacities and therefore right Pancoast tumor was the initial diagnosis. However, her CECT thorax revealed a huge right subclavian artery pseudoaneurysm with severe tracheal compression. This rare condition imposed a significant diagnostic as well as therapeutic challenge. Vascular surgery is the definitive treatment but it is associated with high risks. The exact role of rigid bronchoscopy for airway stenting is unknown due to limited evidence available. Indeed, this form of central airway obstruction may benefit from temporary tracheal stenting whilst the surgical repair of the lesion is planned. It may facilitate early weaning and allows less complicated airway control.
    Matched MeSH terms: Female
  6. Cronin C, Lucas M, McCarthy A, Boland F, Varadarajan R, Premnath N, et al.
    Postgrad Med J, 2019 Mar;95(1121):119-124.
    PMID: 30975724 DOI: 10.1136/postgradmedj-2018-136136
    BACKGROUND: A survey of medical students from the Royal College of Surgeons in Ireland (RCSI) at Dublin, Perdana and Penang in Malaysia was undertaken in an attempt to explore attitudes towards a career in surgery and document potential differences between male and female students' perceptions of a surgical career.

    METHOD: A hyperlink to an online, anonymised questionnaire was distributed to medical students in 3rd, 4th and final year at three RCSI campuses. Basic descriptive statistics were used to describe the responses to individual questions and appropriate statistical tests used to compare male and female responses to questions.

    RESULTS: A total of 464 completed questionnaires were analysed. Almost 40% (n=185) were male and 60% (n=279) were female. Males were significantly more influenced by remuneration than females (p<0.001) towards a choice of surgical career. Females were significantly more influenced in their choice of surgical career by part-time work (p<0.001), parental leave (p<0.001), working hours (p<0.001) and length of residency (p=0.003). During surgical attachments, females were significantly more likely to admit feeling intimidated than males (p=0.002) and males more likely to report feeling confident (p<0.001). Ninety-six per cent of students felt they would be more likely to pursue a career in which they had identified a positive role model, with female medical students three times more likely to have identified a female role model than males.

    CONCLUSION: According to our study, preference for a career in surgery declines with advancing years in medical school for both males and females. Medical students report high levels of feeling intimidated or ignored during their surgical placements, and enthusiasm for surgery reduces during medical school with exposure to this. These findings, along with the importance of role modelling, add further urgency to the need to address factors which make surgery less appealing to female medical graduates.

    Matched MeSH terms: Female
  7. Olesen AP, Amin L, Mahadi Z, Ibrahim M
    Account Res, 2019 04;26(3):157-175.
    PMID: 30982340 DOI: 10.1080/08989621.2019.1607312
    The purpose of this study is to highlight the experiences of individuals who participate in the Responsible Conduct of Research (RCR) training program held at various universities in Malaysia. In response to a mailing request sent to 40 individuals who had undertaken a RCR training program, 15 participants agreed to be interviewed. The results of the study showed that the three main reasons for participating in the training were as follows: anticipation for knowledge gained; personal experience with research misconduct; and establishing a new network of researchers. In terms of the positive effects gained from undertaking the training, the participants highlighted an increased awareness of the issues and problems related to research misconduct; the need to promote integrity in research conduct; a change in the way they conduct their research; and a change in the way they confront and address misconduct. The findings of this study should be valuable for policy makers and those involved in the management of research programs and ethics, as it demonstrated the importance of RCR training in equipping researchers with the necessary knowledge to conduct research responsibly, and to avoid research misconduct.
    Matched MeSH terms: Female
  8. Atari M, Afhami R, Swami V
    PLoS One, 2019;14(4):e0215202.
    PMID: 30998716 DOI: 10.1371/journal.pone.0215202
    Several self-report measures of conspiracist beliefs have been developed in Western populations, but examination of their psychometric properties outside Europe and North America is limited. This study aimed to examine the psychometric properties of three widely-used measures of conspiracist beliefs in Iran. We translated the Belief in Conspiracy Theory Inventory (BCTI), Conspiracy Mentality Questionnaire (CMQ), and Generic Conspiracist Belief Scale (GCBS) into Persian. Factorial validity was examined using principal-axis factor analysis in a community sample from Tehran, Iran (N = 544). Further, the relationships between scores on these measures and hypothesized antecedents (i.e., education, schizotypal personality, information processing style, superstitious beliefs, religiosity, and political orientation) were examined. Overall, we failed to find support for the parent factor structures of two of the three scales (BCTI and GCBS) and evidence of construct validity for all three scales was limited. These results highlight the necessity of further psychometric work on existing measures of conspiracy theories in diverse culturo-linguistic groups and the development of context-specific measures of conspiracist beliefs.
    Matched MeSH terms: Female
  9. Majid A, Burenhult N, Stensmyr M, de Valk J, Hansson BS
    Philos Trans R Soc Lond B Biol Sci, 2018 08 05;373(1752).
    PMID: 29915007 DOI: 10.1098/rstb.2017.0139
    Olfaction presents a particularly interesting arena to explore abstraction in language. Like other abstract domains, such as time, odours can be difficult to conceptualize. An odour cannot be seen or held, it can be difficult to locate in space, and for most people odours are difficult to verbalize. On the other hand, odours give rise to primary sensory experiences. Every time we inhale we are using olfaction to make sense of our environment. We present new experimental data from 30 Jahai hunter-gatherers from the Malay Peninsula and 30 matched Dutch participants from the Netherlands in an odour naming experiment. Participants smelled monomolecular odorants and named odours while reaction times, odour descriptors and facial expressions were measured. We show that while Dutch speakers relied on concrete descriptors, i.e. they referred to odour sources (e.g. smells like lemon), the Jahai used abstract vocabulary to name the same odours (e.g. musty). Despite this differential linguistic categorization, analysis of facial expressions showed that the two groups, nevertheless, had the same initial emotional reactions to odours. Critically, these cross-cultural data present a challenge for how to think about abstraction in language.This article is part of the theme issue 'Varieties of abstract concepts: development, use and representation in the brain'.
    Matched MeSH terms: Female
  10. Tamang MK, Yadav UN, Hosseinzadeh H, Kafle B, Paudel G, Khatiwada S, et al.
    BMC Res Notes, 2019 Apr 30;12(1):246.
    PMID: 31039794 DOI: 10.1186/s13104-019-4282-4
    OBJECTIVES: This study aimed at assessing the nutritional status among the elderly population and factors associated with malnutrition in the community setting in rural Nepal.

    RESULTS: Out of 339 participants, 24.8% (95% CI 20.21-29.30) fell into the normal nutritional status range; 49.6% (95% CI 44.29-54.91) were at risk for malnutrition while 24.8% (95% CI 20.21-29.30) were in the malnourished range, based on Mini Nutritional Assessment scores. Our findings revealed that belonging to a Dalit community, being unemployed, having experience of any form of mistreatment, lack of physical exercise, experiencing problems with concentration in past 30 days and taking medication for more than one co-morbidity was significantly associated with the malnutrition status of the elderly.

    Matched MeSH terms: Female
  11. Nur ‘Aini Eddy Warman, Nurul Yaqeen Mohd Esa
    MyJurnal
    Mycobacterium genavense, a non-tuberculous mycobacterium (NTM), usually affects patients severely immunodeficient from human immunodeficiency virus (HIV) infection or any other immunocompromised states. We reported a case in a 70-year-old female with well-controlled diabetes and history of proximal cystic bronchiectasis. She presented with 2 months history of cough, haemoptysis, and night sweats of which serial sputa were positive for acid-fast bacilli and the culture repeatedly grew M. genavense. Treatment with rifampicin, ofloxacin, and clarithromycin was complicated with drug-induced liver injury and intractable gastrointestinal side effects. We also presented a brief review of relevant literature.
    Matched MeSH terms: Female
  12. Teo GS, Teh LC, Lim JH
    Parasuicide has become an increasingly common response to emotional distress in young adults. The general pattern of parasuicide shows variations among the developing countries. The objectives of this study were to determine the pattern of parasuicide and suicide beside comparing the characteristics between different ethnic groups. The study was a retrospective case review of all parasuicide cases treated in Hospital Sungai Bakap and all suicides from the hospital mortuary from January 2001 to December 2005. We collected data concerning demographic data, information on method used and the circumstances. A total of 189 cases of parasuicide were analysed. There was a significant increase of parasuicide from 26.5 per 100,000 persons in 2001 to 32.1 per 100,000 persons in 2005. Seventy two percent of the cases were female. Indians constituted 64 % of the cases, followed by the Chinese (19 %), Malays (13 %) and foreigners (4 %). The age group 18-30 years ranked at the top, constituting 59.7% of the cases. Majority of the cases were by intentional poisoning and only 2 cases (1.1 %) were intentional injuries by sharp objects. In the past 5 years, the agents implicated were drugs (43.9 %), pesticides (23.5 %), household products (11.8 %), and others (20.8 %). Intentional Paracetamol poisoning had doubled from 11.7 % in 2001 to 23.4 % in 2005 while the use of pesticides had decreased from 32 % in 2001 to 17 % in 2005. Only 2 % of the cases had history of underlying disorders like schizophrenia and personalities disorders. As for suicide, the rates remained relatively unchanged at 5 per 100,000 populations. In this study, the demographic characteristics of suicide differ from parasuicide as suicides were associated with higher percentage of males and Chinese. There were 2 peaks in the age group of 31-40 and above 60 years old. The highest mode of suicide was hanging (53.5 %), followed by pesticide poisoning (25.6 %) and inhaled carbon monoxide (9.3 %).There is a need to improve on prevention and interventions for parasuicide and decrease suicide prevalence. Keywords: parasuicide, suicide, self-harm, Penang
    Matched MeSH terms: Female
  13. Shivji Z, Jabeen A, Awan S, Khan S
    J Neurosci Rural Pract, 2019 4 20;10(2):178-184.
    PMID: 31001002 DOI: 10.4103/jnrp.jnrp_370_18
    Introduction: Most neurophysiology departments around the world establish their own normative data. However, ethnic differences are not taken into account. Our aim was to establish normal nerve conduction studies (NCS) data for routinely tested nerves in individuals of Pakistani (South Asian) origin and to compare with Western published data.

    Materials and Methods: One hundred healthy adults' nerves were assessed, using standardized techniques. Individuals were grouped into age groups. Gender differences were assessed.

    Results: Of the 100 volunteers, 49 were female and 51 were male. Their mean age was 39.8 years. Findings showed statistically significant prolongation of median distal motor latency (DML) and F-wave latency with age and reduction of median, ulnar, and sural sensory amplitudes as age increased. Gender differences showed consistent difference in the normal values for median, ulnar, and peroneal DMLs and respective F-wave latencies, which were significantly shorter in females. Sensory amplitudes of tested upper extremity nerves were significantly lower in males. Comparing with available data, our findings are similar to the Saudi population but significantly different from the American and multiethnic Malaysian populations. Pakistani individuals generally have significantly higher amplitudes and faster conduction velocities with similarities to South Asian studies.

    Conclusions: We recommend normative NCS parameters for commonly tested nerves for the Pakistani population, using standardized techniques to ensure highest quality testing and outcomes.

    Matched MeSH terms: Female
  14. Sahin K, Demirel M, Turgut N, Arzu U, Polat G
    Malays Orthop J, 2019 Mar;13(1):45-48.
    PMID: 31001384 DOI: 10.5704/MOJ.1903.009
    Aneurysmal bone cysts rather than local aggressive lesions of the bone which may arise in any part of the axial or appendicular skeleton. Although several theories are available in the literature, the pathogenesis is still conflicting. We report an exceptional case of an aneurysmal bone cyst in the distal femur of a female cerebral palsy patient who underwent bilateral distal femoral derotational osteotomy and plate-screw fixation operations when she was 11 years old. Twenty-four months after the operation, radiographs showed a cystic lesion in the distal portion of the right femur around the osteotomy site. The diagnosis of Aneurysmal Bone Cyst (ABC) was made and the lesion was treated by curettage with cement application. After 36 months of follow-up, there was no recurrence. This is the first case reported in literature which raises the possibility that an osteotomy could be a cause in the development of an aneurysmal bone cyst.
    Matched MeSH terms: Female
  15. Arabi Z, Md Monoto EM, Bojeng A
    Int Breastfeed J, 2019;14:17.
    PMID: 31019544 DOI: 10.1186/s13006-019-0210-4
    Background: Pre-pubescent girls with chest burns are at risk of complication associated with scarring and impairment in breast development. This case illustrates how burn injuries in childhood in a first-time mother have affected her in terms of breastfeeding.

    Case presentation: In May 2015, a 20 year old first-time mother at 36 weeks gestation was seen in a district health clinic in Kuching, Sarawak in regards to her ability to breastfeed. She had a history of a flame burn at the age of 5 years old to her chest, abdomen, upper limb and part of her trunk. A skin graft was done on her whole chest and abdomen. Despite the injuries, she had pubertal and antenatal breast development. Her abdomen was able to stretch to accommodate her pregnancy. Physical examination showed a pregnancy which corresponded to date. The skin over her chest and abdomen appeared tight with areas of hyperpigmentation and hypopigmentation due to scarring from the skin graft. Breast tissues were palpable over her chest. The areola and nipple tissue were completely absent with complete scarring of the nipple-areolar complex. There was no duct opening to the areola for milk expression or leakage. Counselling regarding her breastfeeding issues was done. She delivered her baby at full term via spontaneous vaginal delivery with no complication. Oral cabergoline 1 mg was given on the first day postpartum. The baby was given infant formula via bottle feeding as the feeding method of choice.

    Conclusion: Counselling plays an important part in the management of a mother with breastfeeding difficulty. Allaying the possible guilty feelings of not being able to breastfeed will fulfil the emotional gap which may arise in a mother with these challenges.

    Matched MeSH terms: Female
  16. Mazlan MZ, Chong SE, Salmuna Ayub ZN, Mohamad NAN
    IDCases, 2019;16:e00520.
    PMID: 31024798 DOI: 10.1016/j.idcr.2019.e00520
    Infection to the meningeal layer causing meningitis is one of the most feared complications of spinal anaesthesia. Anaesthetists will avoid spinal anaesthesia for those who are having skin infection at the puncture site. However in obstetric population, anaesthetist will try their best to avoid general anaesthesia due to its unwanted effects and complications. Strict and appropriate antiseptic measures such as chlorhexidine 0.5% with 70% alcohol has been suggested to reduce risk of transmission of microorganisms into subarachnoid space. We reported a parturient who had generalized tinea versicolor at the lumbar area, safely anaesthetized under spinal anaesthesia through meticulous antiseptic skin preparation who required delivery by caesarean section.
    Matched MeSH terms: Female
  17. Waiho K, Shi X, Fazhan H, Li S, Zhang Y, Zheng H, et al.
    Front Genet, 2019;10:298.
    PMID: 31024620 DOI: 10.3389/fgene.2019.00298
    Mud crab, Scylla paramamosain is one of the most important crustacean species in global aquaculture. To determine the genetic basis of sex and growth-related traits in S. paramamosain, a high-density genetic linkage map with 16,701 single nucleotide polymorphisms (SNPs) was constructed using SLAF-seq and a full-sib family. The consensus map has 49 linkage groups, spanning 5,996.66 cM with an average marker-interval of 0.81 cM. A total of 516 SNP markers, including 8 female-specific SNPs segregated in two quantitative trait loci (QTLs) for phenotypic sex were located on LG32. The presence of female-specific SNP markers only on female linkage map, their segregation patterns and lower female: male recombination rate strongly suggest the conformation of a ZW/ZZ sex determination system in S. paramamosain. The QTLs of most (90%) growth-related traits were found within a small interval (25.18-33.74 cM) on LG46, highlighting the potential involvement of LG46 in growth. Four markers on LG46 were significantly associated with 10-16 growth-related traits. BW was only associated with marker 3846. Based on the annotation of transcriptome data, 11 and 2 candidate genes were identified within the QTL regions of sex and growth-related traits, respectively. The newly constructed high-density genetic linkage map with sex-specific SNPs, and the identified QTLs of sex- and growth-related traits serve as a valuable genetic resource and solid foundation for marker-assisted selection and genetic improvement of crustaceans.
    Matched MeSH terms: Female
  18. Sarmadi S, Izadi-Mood N, Sanii S, Motevalli D
    Malays J Pathol, 2019 Apr;41(1):15-24.
    PMID: 31025633
    INTRODUCTION: In the event of encountering hydropic villi in products of conception specimens, pathologists will have to distinguish complete and partial hydatidiform mole (CHM & PHM) from hydropic abortion (HA). The histological diagnostic criteria are subjective and demonstrate considerable inter-observer variability.

    MATERIALS AND METHODS: This study evaluated the inter-observer variability in diagnosis of CHM, PHM and HA according to defined histologic criteria. Ninety abortus conception specimens were reviewed. Representative haematoxylin and eosin-stained slides were assigned independently to two pathologists who were asked to make a diagnosis of CHM, PHM or HA, and provide a report of the identified diagnostic histological criteria. Kappa value was calculated for the inter-observer agreement.

    RESULTS: There was a total of 36.7% disagreement between two pathologists (K = 0.403, Strength of Agreement = moderate), of which 24.4% and 12.2%, were differentiating PHM from CHM and PHM from HA, respectively. Among defined diagnostic histological criteria, the highest rate of agreement was observed in the identification of cistern formation and hydropic changes (K = 0.746 and 0.686 respectively, Strength of Agreement = substantial).

    CONCLUSION: There was moderate to substantial agreement rate between two pathologists in identification of two essential histologic criteria for diagnosis of molar pregnancies i.e. "hydropic change" and "trophoblastic proliferation".

    Matched MeSH terms: Female
  19. Noh, K.B., Salim, R., Abdullah, M.S., Mohamad, I.
    Malaysian Family Physician, 2018;13(2):36-38.
    MyJurnal
    Foreign body aspiration is commonly described in infants and children. However, recently, a new
    high-risk group was identified among young women, especially those from the Muslim population
    who wear the traditional hair scarf. This is due to the habit of holding the scarf pin in between the
    lips to free hands to adjust the scarf more easily. Talking, laughing, or coughing while fixing the
    scarf may result in inadvertent inhalation of the pin into the tracheobronchial tree. We present a
    case of scarf pin inhalation and the challenges encountered in managing this patient during the
    successful removal of the pin via flexible bronchoscopy under fluoroscopy guidance. This particular
    case was technically challenging for us as the sharp tip of the needle was pointing upward and
    piercing the bronchial mucosa.
    Matched MeSH terms: Female
  20. Anuar, N., Idris, N.S.
    Malaysian Family Physician, 2018;13(3):27-28.
    MyJurnal
    We report a case of acute gonococcal conjunctivitis in a 36-year-old woman who presented with
    eye redness and a history of discharge for one month. Prior to presenting to us, she was treated for
    bacterial conjunctivitis with three courses of local antibiotics by three different clinics after brief
    assessments and without improvement. The final diagnosis of gonococcal conjunctivitis was made
    after a complete history was elicited and supported by the presence of Neisseria Gonorrhoeae in
    the eye swab culture test. She and her sexual partner were treated successfully with intramuscular
    Ceftriaxone and oral Azithromycin. This case highlights the importance of complete history taking,
    including sexual history, which translates into early recognition and treatment, thus preventing
    complications. (Copied from article).
    Matched MeSH terms: Female
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